Home health aides, home care workers, and personal care attendants form the core of the paid home care system, providing assistance with activities of daily living and the personal interaction that is essential to quality of life and quality of care for their clients. High turnover and long vacancy periods are costly for providers, consumers, their families, and workers themselves. In 2002, 37 states identified worker recruitment and retention as major priority issues. Demographic and economic trends do not augur well for the future availability of quality home care workers. Policymakers in the areas of health, long-term care, labor, welfare, and immigration must partner with providers, worker organizations, and researchers to identify and implement the most successful interventions for developing and sustaining this workforce at both policy and practice levels. The future of home care will depend, in large part, on this "third rail" of long-term care policy.

中文翻译：

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直接护理人员：家庭护理政策的第三个方面。

家庭保健助手，家庭护理人员和个人护理人员构成了有偿家庭护理系统的核心，为日常生活和个人互动活动提供帮助，这对于他们的客户的生活质量和护理质量至关重要。高周转率和空缺期长，对提供者，消费者，他们的家庭和工人本身来说都是昂贵的。2002年，有37个州将招聘和留住工人列为主要优先事项。人口和经济趋势对高质量的家庭护理工作者的未来可用性而言并不是一个好兆头。健康，长期护理，劳工，福利和移民领域的政策制定者必须与医疗服务提供者，工人组织，和研究人员，以在政策和实践层面上确定和实施最成功的干预措施，以发展和维持这种劳动力。家庭护理的未来将在很大程度上取决于长期护理政策的“第三条轨道”。